Accutane Update

A few months ago I reported that the acne medication Accutane (isotretinoin) was quietly taken off the market (seeDaily Dose, Nov 13, 2009) because the manufacturer, Roche, was getting sued by so many former users. The lawsuits combined with the availability of a generic version made Accutane a not-so-profitable product. Now I hear that Roche has been ordered to pay $25 million to one patient who blames the drug for causing his inflammatory bowel disease. So I wondered: Is the generic version still available? And should anyone consider using it?

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It turns out that yes, you can still get generic isotretinoin, and dermatologists are still prescribing it. At first this surprised me. Although the research has been mixed, is better skin really worth risking side effects like inflammatory bowel disease, liver damage, suicidal thoughts and serious birth defects? Well, apparently many people think it is. "I prescribe it all the time and feel that it is a safe drug and it changes lives of people with bad acne," says Cameron Rokshar, MD, professor of dermatology at Albert Einstein College of Medicine. As long as you're not pregnant while taking isotretinoin—birth control is an absolute must here—side effects seem to be rare, and for people with really bad acne the benefits may very well outweigh the risks.

"There are many alternatives for the treatment of acne, including oral antibiotics, topical prescriptions, chemical peels, and photodynamic therapy, but Accutane [isotretinoin] remains the most effective treatment," says Dr. Rokshar.

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